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[Surgery for Pineal Region Tumors: Concept and Technical Aspects of Occipital Transtentorial Approach].

Authors :
Akimoto T
Yamamoto T
Source :
No shinkei geka. Neurological surgery [No Shinkei Geka] 2024 May; Vol. 52 (3), pp. 647-658.
Publication Year :
2024

Abstract

This article describes the concept and technical aspects of the occipital transtentorial approach(OTA)for tumor extraction in the pineal region, based on the author's experience and literature review. Awareness of the successful completion of each surgical step is essential. Preoperative preparation and imaging evaluations, with particular attention to the veins and venous sinuses, are especially important. It is also helpful to perform a complete dura incision and inversion up to the edge of confluence, superior sagittal sinus, and transverse sinus. Subsequently, it is necessary to understand the usefulness of adequate dissection in the vicinity of the corpus callosum and internal occipital vein(IOV)so that the occipital lobe can be moved without difficulty. Furthermore, development of the IOV with adequate tentoriotomy facilitates contralateral work. Finally, complete understanding of each step during the bilateral, ambient cistern and cerebellomesencephalic fissure dissection process, where the cerebellar vermis can be moved without difficulty, is necessary for a safe OTA to pineal region tumor extraction.

Details

Language :
Japanese
ISSN :
0301-2603
Volume :
52
Issue :
3
Database :
MEDLINE
Journal :
No shinkei geka. Neurological surgery
Publication Type :
Academic Journal
Accession number :
38783507
Full Text :
https://doi.org/10.11477/mf.1436204958